THE DANGER OF CHANGE - THE KLEINIAN APPROACH WITH PATIENTS WHO EXPERIENCE PROGRESS AS TRAUMA

Personal statement VII
Introduction IX

PART I
Reluctant patients and the fight against change: caught between the paranoid and depressive world 1
1 I hear you knocking but you cant come in 3
2 Mistrust of the good object 16
3 Fighting off the good object 32
4 Problems in receiving 49

PART II
Greed and the dangers of change 65
5 Melanie Kleins theory of greed 67
6 The frightening rumble of psychic hunger 79
7 The impossible dream and the endless nightmare 91
8 Greed, idealization, and insatiability 106
9 Setting the bar too high 120

PART III
Interruptions to the process of change: loss, envy, and the death instinct 135
10 The clinical advantage of the death instinct 137
11 Acting out and the death instinct 152
12 Borderline and psychotic patients 166
13 Oral deprivation, envy, and sadism 182

PART IV
Working toward change in the face of overwhelming odds 193
14 A case study of borderline anxiety 195
15 Bargains, treaties, and delusions 207
16 Symbolization and the good object 224

Summary 238
Bibliography 243
lndex 250